Managing the Ethical Aspects of MACRA
Value is the key driver and organizing principle of MACRA and MIPS. Therefore, it is critical to define value from the view of different healthcare stakeholders.
Identifying the Gap Between Hospital and Free-Standing Prices
One-third of healthcare finance leaders have created separate pricing for certain outpatient procedures versus inpatient procedures to mitigate volume migration from hospitals. Their greatest concerns are how low the pricing should go and how will this pricing impact the bottom line.
The Hospital’s Expanding Authority over Authorizations: The Good, the Bad and the Reality
Heather Kawamoto underscores the need for hospitals to improve on the slow manual process of requesting authorizations as they take on this responsibility.
The Self-Pay Compliance Problem: Payment Security
David King discusses the hospital’s role as “merchant” when patients use credit cards to pay for their care.
HFMA Final Rule Summary: Advancing Care Coordination Through Episodic Payment Models
This document consists of three separate summaries of CMS's final rule implementing three new Medicare Parts A and B episode payment models, a Cardiac Rehabilitation (CR) Incentive Payment Model and modifications to the existing Comprehensive Care for Joint (CJR) Replacement Model.
Bundled Payments: Value-Based Guidance
The authors share insights about bundled payment programs in an ever-changing healthcare environment.
Value Based Payment Coalition Letter
HFMA and other healthcare stakeholders, sent a letter to the White House and Congressional leaders in support of the continued movement toward value-based payment.
Alternative Payment Model Initiatives at Banner Health
Banner Health participates in a variety of alternative payment models, including the Comprehensive Primary Care initiative, Oncology Care Model, bundled payments, and more.
Demand Fuels Expansion of Tiered-Benefit Insurance Products
Stephen T. Swift of BlueCross BlueShield of Western New York writes that collaboration with local healthcare providers spawned a popular tiered-benefit insurance product.
Bundled Payments for Self Pay Patients
Consumers are gaining access to a true healthcare marketplace as hospitals and physician groups offer discounted bundled-payment services for patients with no insurance or high deductibles.